进行性斑状色素减少症的临床及实验研究-clinical and experimental study on progressive macular pigment reduction.docx

背部、腹部，可于近中线处融合成片状，并可泛发于颈部、四肢近端等。4）Wood灯下可见色素减退区存在局限性点状红色荧光，皮肤共聚焦激光扫描显微镜观察示皮损区‘色素环’正常，但与周围正常皮肤相比其内所含的色素颗粒减少。5）皮损区细菌培养可培养出痤疮丙酸杆菌，真菌镜检及培养阴性。6）组织学检查示皮损区黑素细胞数量无明显减少。7）超微结构观察皮损区及皮损边缘外观正常皮肤内可见较多的膜结合体（内含多个体积较小的II-IV期黑素小体）。过氧化苯甲酰联合NB-UVB是治疗进行性斑状色素减少症的一种有效的方法。【关键词】进行性斑状色素减少症；致病菌；黑素细胞；黑素小体ClinicalandexperimentalstudiesofProgressivemacularhypomelanosisPost-graduate:XingangWuPreceptor:Prof.AieXu（AnhuiMedicalUniversityAffiliatedHangzhouHospital，Hangzhou，310009）ABSTRACTBackground：PMHisanotcommondisorderinskinpigmentationespeciallyamongdarkerskinnedindividuals,withthefirstreportin1988byGuillet[1].Theclassicalclinicalcharacteristicsareilldefinednummular,hypopigmented,nonscalymaculesonthefrontandthebackoftruck,withconfluenceofthemaculesinandaroundthemidline.Itoftenmadediagnosticerrorswithotherhypopigmenteddiseases(suchaspityriasisversicolor,hypopigmentationafterinflammation,etc).ThecauseofPMHisstillunknowntodate.Object:TosummarizetheclinicaldiagnosticcriteriaofProgressivemacularhypomelanosis(PMH),andcarryoutexperimentalstudiesfromvariousaspects,investigatesthepathogenesisofPMHandsummarizeditsclinicaldiagnosticcriteria.Methods:ToutilizeWood’slampandConfocalLaserScanningMicroscopytoobservethelesion’sfeature,microbiologicalculture,tomakeuseofS-100andTRP-1immunohistochemicalstaininganalysisthelesionsareamelanocytes’quantity,electronmicroscopyobserveitsultrastructuralfeatures,andtocarryoutmelanocyetesculture.Results:UnderWood’slampexamination,thelesionofPMHshowedthepunctiformredfluorescence.ConfocalLaserScanningMicroscopyObservationofthelesionfinditspigmentedringshowcomplete,butcomparedwiththesurroundingnormalitsmelaningranulewasdecreased.Themicrobiologicalculturedshowproducttheredfluorescence’sgram-positivebacilli,identificationisPropionibacteriumacnes.S-100stainingshowingthebasallayerpositivecellsinlesionareas(8.25±0.96),comparedwiththesurroundingnormalskin(8.75±1.71)hasnostatisticalsignificance(P0.05);TRP-1stainingshowedthebasallayerpositivecellsinlesionareas(4.25±0.96)comparewiththesu